Type 2 diabetes sufferers are being urged to look out for a killer genital infection that rots your privates

New research has found a link between SGLT2 inhibitors and Fournier gangrene - a flesh-eating bacteria that affects soft tissue in the genitals.

The potentially life-threatening infection is more common in men as it targets the scrotum or penis, where there are plenty of small crevices that trap bacteria.

It can also develop in perineum - the area between the anus and vulva or scrotum - and around the anus, meaning women are also at risk.

SGLT2 inhibitors are used to help people with type 2 diabetes improve their glycemic control by preventing the kidney from reabsorbing glucose.

In the UK they are better known as Forxiga (Dapagliflozin), Invokana (Canagliflozin), and Jardiance (Empagliflozin).

While this increases the amount of glucose excreted in the urine, it can also lead to urinary tract infections.

Flesh-eating infection

Now, researchers from the US Food and Drug Administration (FDA) say they have also found the drugs are linked to Fournier gangrene.

In the study, experts reviewed reported cases of the infection in patients using SGLT2 inhibitors compared with those taking antiglycemic agents.

They found that since the drug received market approval in 2013, there had been 55 cases among diabetic patients.

What is type 2 diabetes and who is at risk?

Type 2 diabetes is the more common form of the disease - accounting for between 85 and 95 per cent of all cases, according to Diabetes UK.

It develops when the insulin-producing cells in the body are unable to produce enough insulin.

It can also be triggered when the insulin that is produced doesn't work properly.

Typically, people are diagnosed with type 2 diabetes from the age of 40, but there are some exceptions.

In people from southern Asia the disease can appear as early as 25.

And the condition is becoming more prevalent in children and teenagers of all ethnicities.

Experts suggest the rising rates of type 2 diabetes is due to the obesity epidemic - a key cause of type 2 diabetes.

Type 2 diabetes can be treated with drugs, and many people can reverse their condition by adopting a healthy lifestyle.

On November 22, 2018, it was revealed that there are nearly 7,000 children and young adults under the age of 25 with type 2 diabetes in England and Wales.

That's almost ten times higher than the previously reported number, according to Diabetes UK.

The Obesity Health Alliance said it was "hugely concerning" to see so many young people diagnosed with type 2 diabetes.

By comparison, the team found just 19 cases in patients taking over antiglycemic agents over the last 35 years.

In a statement about the findings, published in Annals of Internal Medicine, the researchers said: "Awareness of the association between Fournier gangrene and SGLT2 inhibitor use may be an important factor in an informed prescriber-patient discussion regarding appropriate diabetes therapy."

What is genital gangrene?

Early symptoms will begin within 24 hours of being infected and often start with a general feeling of being unwell.

Sufferers may also notice pain or swelling in the genital area.

These symptoms will continue to worsen and the tissues may also start to develop a foul smell, as a result of dying or rotting tissue.

Rubbing the infected areas of skin will make a distinct sound, similar to popping or cracking due to the friction of gas and tissues moving against each other, according to Medical News Today.

SGLT2 inhibitors have been proven as a safe and effective treatment for Type 2 diabetes, and anyone taking them should not unduly worry

Dan HowarthDiabetes UK

Antibiotics are used to treat the infection and surgery is needed to remove tissue, such as all of part of the penis and testicles.

It's estimated between 20 and 40 per cent of people with the infection die due to complications, according to an article published in the journal Urologia Internationalis.

Dan Howarth, head of care at Diabetes UK, said: “While Fournier gangrene is already a recognised, if rare, complication of all types of diabetes, this research adds weight to the evidence that there is a connection between SGLT2 inhibitors and the risk of developing an infection.

"It must be stressed, however, that Fournier gangrene remains a very rare side effect of these drugs.

"SGLT2 inhibitors have been proven as a safe and effective treatment for type 2 diabetes, and anyone taking them should not unduly worry, or change or stop taking their medication without the advice of their healthcare team."

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"If anyone taking SGLT2 inhibitors notices any unusual symptoms – including a strange smell or swelling in the genitals, fever or unexpected pain – they should seek medical advice as soon as possible.

"For healthcare professionals, our advice when starting their patients with type 2 on these drugs is to be vigilant, ensure ongoing review of the treatment and, if Fournier gangrene is suspected, to take their patient off SGLT2 inhibitors, and begin treatment for the infection with all urgency.”

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